Category: Advocacy

Advocacy Alert: Home Health Care Access Protection Act

Please encourage your congressional legislators to add their names as cosponsors of the Home Health Care Access Protection Act (H.R. 5803; S. 3315) introduced by Reps. Jim McGovern (D-MA) and Walter Jones (R-NC) and Sens. Susan Collins (R-ME) and Russ Feingold (D-WI).

In light of the recent CMS rule that proposes to cut home health payments by 3.79 percent in 2010 and 3.79 in 2011 based on an unfounded allegation of “case mix creep,” this legislation is vitally important to preserve access to home health services because it would establish a fairer and more transparent process for evaluating case mix changes. Home health advocates also should ask their legislators to convey these significant concerns about payment cuts to CMS.

  • Click here and enter your address to find your federal legislators and their contact information. To access the text of the House bill and a list of House cosponsors, click here. To see the text of the Senate bill and a list of Senate cosponsors, click here.
  • If your legislators have not yet cosponsored H.R. 5803 (the House bill) or S. 3315 (the Senate bill), please contact their offices and encourage them to do so. When calling, ask to speak with the staffer who handles Medicare issues. For talking points, click here.
  • To send an email on this issue to your members of Congress using the NAHC Legislative Action Network, click here. We encourage you to edit the sample email provided there by adding information about your own background and experience and the impact these payment cuts could have on home health patients in your state.

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Nurse Delegation Bill Moving Through House of Reps

The Home Care Alliance’s state bill on nurse delegation, known as S.860, An Act Relative to Home Health Aides, is moving from one House committee to another on its way to what will hopefully be a vote before the full 160-member House of Representatives.

The legislation has moved to the House Committee on Bills in the Third Reading and we still need your help in advocating. Send a message from our Legislative Action network (top message) today!

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Ask Congress to Support Home Health Planning Improvement Act

The National Association for Home Care & Hospice (NAHC) is planning a “virtual lobby day” on July 22 in an effort to boost cosponsors for the Home Health Care Planning Improvement Act (S.2814, H.R.4993). The legislation would allow Nurse Practitioners (NP’s), Clinical Nurse Specialists, and Physician Assistants (PA’s) to certify and make changes to home health care plans.

The House version has 80 cosponsors and the lead sponsors, Congresswoman Allyson Schwartz (D-PA) and Congressman Walter Jones (R-NC), are seeking to get that number up to 100 prior to the August recess.

Click here and enter your information to find your federal legislators and their contact information. To access the text of the House bill and a list of House cosponsors, click here. To see the text of the Senate bill and a list of Senate cosponsors, click here.

A message is also available on the Legislative Action Network (second to last prepared message) for those looking to email and not call.

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Nurse Applauds Congressman McGovern for Visit

In appreciation of Congressman Jim McGovern’s recent home visit with Community VNA of Attleboro, the nurse who the Congressman accompanied wrote an Op-Ed praising McGovern’s support of home health issues. The editorial appears here in the Attleboro Sun-Chronicle.

Sandy Legg-Forgiel was the registered nurse and telemonitoring coordinator for Community VNA who brought Congressman McGovern on the visit to the home of a patient on telehealth services. In addition to his existing support, McGovern agreed to sign on to an initiative that would expand the use of remote patient-monitoring services.

Congressman McGovern is a leading champion in Washington DC for the home health industry having established the Home Health Working Group in Congress and has filed or signed on to several pieces of legislation throughout his career that were of benefit to home care.

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HCA Offers Comments on PECOS

The Home Care Alliance joined agencies and organizations from across the country in submitting comments on the Interim Final Rule requiring physicians enroll in PECOS (Provider Enrollment, Chain and Ownership System).

The Alliance submitted comments because the regulation change, although directly related to physicians, would prohibit home health agencies from submitting claims to Medicare for reimbursement if the physician was not enrolled in the online PECOS system.

Due to inquiry from federal elected officials, letters and comments, the Centers for Medicare and Medicaid Services (CMS) issued a notice clarifying that they will, “for the time being, not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.”

The notice continued that “While the regulation will be effective July 6, 2010, CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS.  However, until the automatic rejections are operational, providers should not see any change in the processing of submitted claims, they will continue to be reviewed and paid as they have historically been reviewed and paid.”

The Home Care Alliance’s comments call for a delay in the implantation of the regulation to October 1, 2010 and also to hold home health agencies and other Medicare part B providers harmless for claims submitted prior to that date for services ordered by physicians not listed in PECOS.

To take action, fill out this form and send an email to your federal elected officials.

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HCA Issues PECOS Physician Notice for Agencies

In an effort to alert physicians referring patients for Medicare home health services about PECOS (Provider Enrollment, Chain and Ownership System), the Home Care Alliance has drafted an “Important Notice to Physicians“ document for members to use.

The document summarizes the PECOS issue as well as instructions for physicians on the enrollment process.

For more information and background on PECOS, visit this blog post.

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Comment to CMS on PECOS, and Lobby Congress

For those looking to comment on the PECOS (Provider Enrollment, Chain and Ownership System) issue, visit this link on regulations.gov and click on “submit comment.”

HCA strongly suggests that members also send a message to Congress (scroll all the way down to the last message on the list) and call the office of Senator John Kerry and US Representative to follow up on the Alliance’s letter and alerting their offices to the timeliness and urgency of the matter.

If you’re unsure who represents you in the US House of Representatives, click here.

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Medicare Ruling Puts Home Health Patients at Risk

A provision in the Patient Protection and Affordable Care Act published recently by the Centers for Medicare and Medicaid Services (CMS) states that, as of July 6th, home health agencies will be prohibited from submitting claims for reimbursement from physicians who have not enrolled in a new online system.

Failure to register in the Medicare Provider Enrollment, Chain and Ownership System, or PECOS, would also block these physicians, who can still see Medicare patients, from referring new patients for Medicare-covered home health services.

At issue is that CMS has not adequately educated physicians about this new requirement.  The result is that as many as 50% of physicians in Massachusetts (NAHC estimates 20-40 percent nationally) have not registered on PECOS.  Moreover, the registration and approval process can take several weeks, so even if physicians were to register immediately, their status would not be approved by the July 6 deadline.

HCA, along with the VNA of Boston and other agencies and organizations are urging the Centers for Medicare and Medicaid Services and Congress to delay implementation of the rule until such time as physicians have ample time to enroll and also to hold harmless the home health providers that will suffer from the abrupt transition.

What to do:

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MA Senate Passes Nurse Delegation, Bill Moves to House

The Home Care Alliance is applauding the state Senate’s passage of the Nurse Delegation bill (S.860) and is urging the House of Representatives to follow suit.

S. 860 would refine the Commonwealth’s Nurse Practice Act (NPA) to allow appropriate nurse delegation practices to include delegation of medication administered by home health aides in the home setting.

Thanks to the advocacy of HCA members and the work of supporting organizations, the bill moves one step closer to the Governor’s desk and lobbying efforts are now directed at the House.

An NEW email message aimed at State Representatives is available in the Legislative Action Center. Just click on the message regarding Nurse Delegation. If you choose to call your local State Representative, a fact sheet is also available as a guide.

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Joint Letter Supporting Nurse Delegation Sent to Senate President

Organization leaders supportive of the Home Care Alliance’s Nurse Delegation bill (S.860) signed onto a letter aimed at Senate President Therese Murray and urging her to bring the proposal before the full Senate for debate.

The joint letter initiated by the Home Care Alliance is also copied to Senator Frederick E. Berry, who is Chairman of the Senate Committee on Ethics and Rules, which is where the bill currently sits. The next step for the legislation would be a formal session where state senators would debate the matter, but with time running down the Alliance and the bill’s supporters are working to advance the issue to that vital step.

Go to the HCA Legislative Action Center and click “Please Advance S.860 for Better Home Health” to send a letter to the Senate Committee on Ethics and Rules, or call Senator Berry’s office at 617-722-1410.

Some organizations, including the Massachusetts Association of Registered Nurses and the Massachusetts Association of Nurse Executives, are in support of S.860, but were not able to sign onto the letter.

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